DOI: 10.36347/sjmcr.2019.v07i01.021

Pages: 69-72

Mediastinal teratomas account for 10% of mediastinal tumors, mainly affecting the young population. There are two types of teratomas: mature (benign) and immature. The radiological presentation is variable given the great variety of the tissues constituting it: epithelial and muscular tissues, fat, liquid, cartilage and even teeth. We report the case of a 27-year-old female, with no pathological history, who consulted for a progressive dyspnea, in a context of apyrexia and general state preservation. The clinical examination found a dyspnoeic patient with a left fluid effusion syndrome. The chest X-ray has shown a left lung opacity. The patient underwent a thoracic drainage bringing back 600cc of purulent liquid at the beginning then herematic but the patient remained dyspnoeic. The cytobacteriological analysis was negative. A thoracic CT was performed revealing an abundant left pleural effusion, containing a three component mass :tissue, fat and calcium ; suggestive of a teratoma with ultrasound and MRI in favor of a pleural localization. The patient underwent a thoracotomy revealing a large solido-cystic mass with a large mediastinal implantation base pushing up the left lung and very adherent to its lower lobe,histologicaly compatible with a mature teratoma. Teratomas represent 50% to 70% of mediastinal germ tumors, their radiological presentation is often suggestive of the diagnosis, but in some cases - not as rare - they can simulate a massive pleural effusion, and should therefore be included in the list of diagnoses to evoke in front of an opaque hemi-thorax especially in the presence of calcification and in the young population.